Thursday, August 28, 2014

Slow growing children

So, I'm still stressing out about Benjamin growing properly. Today while Miriam was at preschool I looked up all the stats I have for him to see if he was ever in the 25th percentile and all my records show that he's just always been small. I even called the clinic today to check his records. This flagged my doctor so she called me back (I hadn't intended to bug her at all, I promise) to explain that the 25th percent figure came from his adjusted chart. And now he's sitting at the 5th percentile and she's not happy about it.

How do I explain to my doctor that my child is healthy?

Rachel weighed 26 lbs. at two years (she's always been my middle-ground child), so we'll leave her out of this discussion. But Miriam only weighed 23 lbs. at two years.

Benjamin also weighed in at 23 lbs. at his two-year check up.

But I guess 23 lbs is within the 5–10% range for girls and is below the 5th percentile for boys.

That doesn't change the fact that Miriam was 15 lbs at 4 months old—putting her between the 50th and 75th percentile—and that she dropped down to the 5–10th percentile by the time she was two.

Benjamin was apparently all the way up in the 25th percentile for his adjusted chart at 4 months (when he weighed 12 lbs). But his percentile has dropped quite a bit (like below the 5th percentile).

How is it that Miriam's doctor concluded that she was a healthy breast-fed baby ("Must've been making some creamy milk right around then!" he quipped) and Benjamin's doctor seems about ready to diagnose him with failure to thrive?

The World Health Organization seems to feel that breast-fed babies' weight gain does taper off around six months. They start growing slower than their formula-fed peers (whereas before that time they can grow faster).

I have a feeling my doctor is using the CDC charts, since that's the norm here. Should I ask her to check him on the WHO charts? I can't seem to find a WHO chart adjusted for prematurity...and I'm not exactly sure how to adjust for prematurity myself. Do I just take x-number of weeks off his age when I plot him on the chart (where x=the number of weeks premature)?

Also, I thought that premature babies were supposed to "catch up" to their peers by around two years. Benjamin is caught up developmentally, I think. His doctor wasn't at all concerned that the boy didn't even begin babbling until he was eighteen months old (I was concerned), but now he's a talking, running, jumping, happy little boy.

He's just small. But I thought we allowed premature babies to be smallish. I was told in the hospital that he should catch up to their peers and "land on the regular growth chart by two years of age." Benjamin did that. He's on the chart. So why is my doctor freaking out?

Is it because he's not as "chunky" as he was when he was four months old? Because all of my children chunked out at four-months old...and then their growth tapered off.

Seriously, when my doctor weighed Miriam at her four-month check up he actually did it twice because he didn't think it was possible for her to have gained that much weight—but she had. And then she started tapering off. No one expected her to stay in the 75th percentile.

I guess I'll just keep feeding Benjamin (because I was totally considering quitting that habit before...not) until I take him in for his weight-gain check in four months.

For lunch to day he had a whole container of yogurt (perhaps with a couple tablespoons of sour cream mixed in), a banana, and a plate left-over noodles with melted cheese. Oh, and half a gingerbread man cookie that Miriam shared with him when we picked her up from preschool. And he had a bowl of graham crackers just before we left to pick her up.

5 comments:

  1. I think your children are just blessed with your high metabolism. If you know they are eating and healthy, then the doctor's opinion is just her opinion. She probably comes across children whose parents neglect them so she naturally has to flag these things to cover all the bases, but we all know you feed your children and are an excellent mother!

    Just my non-doctoral opinion of this matter. :) Do you worry that he has some hidden condition? Like a parasite that is taking all his nutrients? If not, I'd just assume Benjamin is like you - naturally thin. A wonderful blessing in a world that prizes thin people over fat ones!

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  2. If this doctor stresses you out so much, can you change doctors? If you don't feel comfortable sharing what you just wrote with her, then maybe you need a different doctor.

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  3. I would trust your mother's instincts on this one. Benjamin seems like a perfectly happy and active boy. Don't let anyone tell you otherwise!

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  4. I mean, trust your mother's instincts, but also trust your own instincts as a mother. I meant the latter in my previous comment, but I suppose I also mean the former!

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  5. I'm not so sure why doctors get so crazy about this. I think maybe they just have to go through some steps of grieving to come to terms with the fact that the kids aren't fat like a lot of the american kids they see. I'm just saying ;). Although I feel bad for those parents too because j is always hassling parents about not giving their chubby kids soda or free for all milk...so I guess there is that to. I don't think they are going to catch up. I think they have until two to do it, but if they don't the path is fairly set. I think we just need to be ok with them being shorter than they maybe would have been had they not been premature. We know plenty of short nice people ;). It will be fine. I think they don't use WHO charts here because if they did most kids would be considered obese. I saw the babies they use those charts on, they are pretty tiny.

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